Individual
JAMES W. LAFOLLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2605 E. CREEK'S EDGE DR., BLOOMINGTON, IN 47401
(812) 332-9496
(812) 339-5229
Mailing address
550 LANDMARK AVE., PO BOX 550, BLOOMINGTON, IN 47402-0550
(812) 332-9496
(812) 339-5229
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01021192A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100182460
—
IN
Enumeration date
06/16/2005
Last updated
09/26/2008
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